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NPI Code Detail

MEDICARE: MARSHA KADDO MOUAWAD LMHC

MEDICARE: MARSHA KADDO MOUAWAD LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor010093-01NY

General Provider Information

NPI Number : 1285354241
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARSHA KADDO MOUAWAD LMHC
Provider Business Mailing Address
First Line : 113 WAGER RD
Second Line :
City : WYNANTSKILL
State : NY
Zip : 12198-3431
Country : US
Telephone Number : 518-268-9259
Fax Number :
Provider Business Practice Location Address
First Line : 139 VLY RD
Second Line :
City : ALBANY
State : NY
Zip : 12205-2212
Country : US
Telephone Number : 518-608-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2022
Last Update Date : 08/30/2022

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